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Update On Orthognathic Surgery Long Term Stability And Relationship To Airway Leslie A. Will. Episode 45. IOC 2020

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Farooq Ahmed

Leslie described 2 studies answering the question of the changes of orthognathic surgery, first on the airway, second in the stability of a 3 part maxilla using CBCTs.

 

 

  1. Airway changes investigated with CBCT on 36 orthognathic patients

Significant changes (mainly oropharyx) in volume were:

  • Maxillary advance: 76% increase
  • Mandibular advance: 49% increase
  • Bimaxillary procedure: 143% increase

 

What variables resulted in the increase in volume?

  • Bimaxillary procedure
  • Every 1mm of advancement of greater palatine foreman = 2000mm3
  • Every 1mm downwards movement of PNS = 1000 mm3

 

What didn’t change?

  • No significant change on nasopharynx

 

  1. Stability of 3 part maxillary orthognathic surgery and BSSO advancement investigated with CBCT for 29 orthognathic patients.

Study follow up 18 months with repeat CBCT

  • 3 part maxilla surgery changes:
    • Posterior maxilla relapsed superiorly 1.5-2mm
    • Advancement relapse 5mm
    • No expansion relapse
  • BSSO advancement changes:
    • Mental foreman relapse 2.5mm
    • Interlingula distance decrease 2.8mm
  • Condyles:
    • Immediate post operatively condyles move posteriorly 0.6-1.4mm and medially 1.2mm
    • 18 months post operatively condyle returns pre-operative position
  • Overall
    • Bimaxillary advancement: relapse 18%

 

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